Richard Weil, MEd, CDE

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Can I get stronger without building big muscles?

Importantly, strength isn't just a function of mass. It's also a function of something called "neurological patterning." In layman's terms, patterning is when the brain sends electrical signals via the nervous system to muscles to make them contract. For example, when you think about walking down the street, bending over to pick something up, or any other movement for that matter, the brain first processes the thought and figures out what muscles are needed to make the move and then sends the signal over the nerves to the particular muscles that are necessary for the movement. The muscles move (and so do you) once the signal reaches them. (See "How muscles work" for more detail.)

The good news here is that muscle patterning improves within days of starting a weight-lifting program, even without any increase in muscle mass. This explains the 113% increase in strength experienced by the residents of the nursing home in Boston in the previously cited study. In a different study that specifically investigated this phenomenon, 67- to 81-year-old men lifted weights for six weeks while hooked up to electrodes that measured their nerve and muscle patterning (an electromyogram machine). The results showed that the men experienced a 25% increase in the patterning of the muscle along with a 35% increase in strength, all without significant increases in size.

What happens to endurance as we age?

Endurance decreases as we age. In one extensive study of more than 3,000 70-79-year-old men and women, researchers investigated the relationship between the speed at which these subjects walked ¼ of a mile and their risk of premature mortality, cardiovascular disease, and mobility limitation. The results showed that those with the slowest walk times (>6 minutes) had a higher risk of death, cardiovascular disease, and mobility limitation than those who walked the distance in less than four and a half minutes. In fact, every additional minute of walking time was associated with higher and higher degrees of risk; approximately 13% of the participants could not even complete the distance due to fatigue or symptoms such as breathlessness, cramping, etc.

There's good news that should serve as an encouragement to all of us when it comes to fitness, walking endurance, and health. In a classic study of walking and mortality in 700 men enrolled in the Honolulu Heart Program, the mortality rate among the men who walked less than one mile per day was nearly twice the rate of those who walked more than two miles per day. (Studies of women showed similar results). In another study, data collected on more than 41,000 men and women from 1990 to 2001 were analyzed to find the relationship between walking and mortality. It was reported that men and women who walked 30 minutes or more per day during the study period had fewer deaths than those who walked less than 30 minutes. Interestingly, even men and women who smoked or were overweight were protected from early death if they walked more than 30 minutes per day.